Download Self Harm Early Intervention and Support in

Title:
Self-Harm: Early Intervention and Support in Schools
Date:
April 2016
1.
Overview
While self-harm and suicide are separate issues, there are clear and
established inter-dependencies. Individuals who self-harm are
communicating emotional distress as are those who attempt or complete
suicide. In responding to these issues, the primary responsibility of
education settings is to safeguard children and young people to minimise
the risk of self-harm or suicide and in achieving this, it is essential that
all emotional distress is taken seriously.
This policy, however, focuses primarily on the issue of self-harm and the
responsibilities of both the Education Department (ED) and education
settings in responding to this.
Research indicates that that up to one in ten young people engage in
self-harming behaviours. While prevalence is significantly higher across
the 11-19 population, all school staff have a significant and central role
both in responding to and supporting pupils who self-harm and the peers
of those pupils engaging in self-harm.
This policy aims to support education settings in responding to this issue.
2.
Scope
This policy applies to all staff in education settings.
3.
Responsibilities and distribution
Managers are responsible for ensuring that all staff read and understand
the policy and that all members of the school community are aware of
their responsibilities under it.
4.
Policy/ standards
It is the responsibility of the ED to:
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I.
Support education settings to ensure that staff feel competent and
confident in responding to and supporting pupils who are either
suspected or actively engaging in self-harming behaviour. In this
respect, a focus on early intervention and support. In achieving
this;
II.
Provide comprehensive guidelines for education settings to
support their activity in this area;
III.
Support all schools directly or indirectly by providing a regular
visiting service from appropriately qualified professionals (e.g.
Educational Psychology);
IV.
Provide suitable continuing professional development (CPD) for
the schools’ and wider education workforce and;
V.
Work with partner agencies to establish and clarify thresholds to
support education settings in their decisions to either signpost or
consider appropriate, onwards referral and involvement from more
specialist services e.g. Child and Adolescent Mental Health
Service (CAMHS).
It is the responsibility of education settings to:
5.
I.
Develop, publish, disseminate and implement a policy to inform
practice in this area. Appendix A provides a template policy.
II.
Keep the policy under review within the school development plan
(SDP).
III.
Identify a named person to oversee/ co-ordinate the school’s
responsibilities in this area. This might be the designated teacher
for safeguarding.
IV.
Ensure staff are both suitably developed through structured CPD
and appropriately familiar with ED guidelines in responding to selfharm in schools.
Further information and related documents
The document ‘Self-harm – Guidelines for Schools’ represents good
practice guidance for schools on behalf of the ED. This document further
references a range of additional information and related documents.
6.
This policy has been developed in consultation with CAMHS.
Recommendations and Guidelines
It is recommended that education settings review and update their
existing policies to reflect this ED policy.
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CHANGE HISTORY
Version
0.1
0.2
Date Issued
April 2016
Issued by
Reason for Change
First Draft for review
Updated to reflect new Department name and job
titles/contacts.
Principal
Educational
Psychologist
APPROVAL
Presented To
Senior Management
Team
ESC Minister
Approved by:
Date
ADDITIONAL INFORMATION
Planned review date:
Associated policies
Distribution:
Name
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Reference
Appendix A
Template Policy
Self-harm: Early Intervention and Support in Schools
1. Introduction
Research indicates that up to one in ten young people engage in self-harming
behaviours. School staff play an important role both in responding to self-harm
and in supporting pupils and peers of those pupils currently engaging in selfharm.
2. Scope
This document describes the school’s approach to self-harm. This policy is
intended as guidance for all staff including non-teaching staff and
Governors (where appropriate).
This document should be read in conjunction with the Education Department
document ‘Self-harm – Guidelines for School Staff’ which provides
comprehensive guidance for schools in responding to and supporting pupils
presenting with self-harming behaviour.
3. Aims
This policy aims to:
•
•
•
•
Increase staff understanding and awareness of self-harm
Alert staff to warning signs and risk factors
Provide support for staff responding to pupils who self-harm
Ensure that pupils who self-harm and their peers are able to access
appropriate support
4. Definition of Self-Harm
Self-harm is any deliberate, non-suicidal, behaviour where the intent is to
cause harm to one’s own body. This might include, for example:
•
•
•
•
•
•
•
•
Cutting, scratching, scraping or picking skin
Swallowing inedible objects
Taking an overdose of prescription or non-prescription drugs
Swallowing hazardous materials or substances
Burning or scalding
Hair-pulling
Banging or hitting the head or other parts of the body
Scouring or scrubbing the body excessively
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While self-harm and suicide are separate, individuals who self-harm are
communicating emotional distress as are those who attempt or complete
suicide. Clearly it is essential that all emotional distress is taken seriously to
minimise the chance of self-harm and suicide.
5. Risk factors
The following ‘risk’ factors, particularly in combination, may make a young
person particularly vulnerable to self-harming behaviour:
Individual Factors
Family Factors
•
Depression/
anxiety
•
Unreasonable
expectations
•
Poor
communication
skills
•
•
Low self-esteem
•
•
Poor problemsolving skills
•
Hopelessness
•
Impulsivity
•
Drug or alcohol
abuse
•
Unreasonable
expectations of
self
Social Factors
•
Neglect or
physical, sexual or
emotional abuse
Difficulty in
making
relationships/
loneliness
•
Poor parental
relationships and
arguments
Being bullied or
rejected by
peers
•
Persistent
experiences of
perceived
failure
•
Child being in
residential care
•
Depression, selfharm or suicide in
the family
6. Warning signs
School staff may become aware of warning signs which indicate a pupil is
experiencing difficulties that may lead to thoughts of self-harm. These warning
signs should always be taken seriously and staff observing any of these
warning signs should share this information with and seek further advice from
the school’s designated teacher for safeguarding.
Possible warning signs include:



Changes in eating/sleeping habits (e.g. pupil may appear over tired if
not sleeping well)
Increased isolation from friends or family, becoming socially withdrawn
Changes in activity and mood e.g. more aggressive or introverted than
usual
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





Lowering of academic achievement
Talking or joking about self-harm
Evidence of substance misuse (e.g. drugs or alcohol)
Expressing feelings of failure, uselessness or loss of hope
Changes in physical appearance e.g. becoming unkempt, adopting a
minority clothing style
Variable school attendance and/or persistent lateness
7. Responding to pupils who self-harm
Responding to a disclosure of self-harm
Pupils may choose to confide in a member of school staff if they are
concerned about their own welfare, or that of a peer. School staff may
experience a range of feelings in response to self-harm disclosure (e.g. anger,
sadness, shock, disbelief, guilt, helplessness, disgust and rejection). Staff
should, however, try and maintain a supportive and open attitude in order to
offer the best possible help to pupils. Clearly, a pupil who has chosen to share
their concerns with a member of school staff is showing considerable courage
and trust.
Confidentiality and information sharing in school
Pupils need to be made aware that it may not be possible for school to offer
confidentiality. If school considers a pupil is at risk of seriously harming
themselves then confidentiality cannot be kept. It is important that staff do not
make promises of confidentiality that cannot be kept - even if a pupil puts
pressure on an individual to do so.
Any member of staff aware of a pupil engaging in or suspected to be at risk of
engaging in self-harm, should consult the school’s Designated Teacher for
Safeguarding. Following the report, the designated teacher will decide on the
appropriate course of action and in line with the school’s/ Department’s policy
and procedures for safeguarding. In all cases a written record (signed and
dated) will be made and saved within the pupil’s file.
Initial response from staff
Depending on the circumstances of the actual or suspected self-harming
behaviour, specific consideration should be given to the following:





In the case of an acutely distressed pupil, the immediate safety of the
pupil is paramount and an adult should remain with the pupil at all
times
If a pupil has self-harmed in school, a first aider should be called for
immediate help (where appropriate)
Immediately removing the pupil from lessons, if remaining in class is
likely to cause further distress to themselves or peers
Arranging appropriate professional support/assistance from schoolbased services (e.g. school counsellor)
Onwards referral to more specialist services and support within Health
and Social Services
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In the case of a pupil who has expressed suicidal thoughts and feelings, staff
must remain with the pupil until the pupil can be accompanied to meet with the
school’s designated teacher for safeguarding. At no time should the pupil be
left unsupervised. Consideration will be given to the need to contact parents/
carers to inform them of the situation and (as appropriate) ask them to collect
the pupil to take them to hospital.
8. Further considerations
Peer group
It is important to encourage pupils to let school know if one of their group is in
trouble, upset or showing signs of self-harming. Friends can worry about
betraying confidences. As such, friends need to know that self-harm can be
dangerous and that by seeking help and advice for a friend they are acting
responsibly and being a good friend. Peers should also be reassured that their
friend will be treated in a caring and supportive manner and that they are not
responsible for either the well-being or choices of their friend. The peer group
of a young person who self-harms may value the opportunity to talk to a
member of staff either individually or in a small group. Any member of staff
wishing for further advice on this should consult with the school’s Designated
Teacher for Safeguarding.
Contagion
When a pupil is self-harming, it is important to be vigilant in case close
contacts with the individual are also self-harming. Occasionally, schools
discover that a number of pupils in the same peer group are harming
themselves and this behaviour can be viewed as an ‘acceptable’ coping
strategy. This is known as contagion and can potentially raise levels of
anxiety both with the pupils concerned, their peers and within the school
community. In such cases, school should liaise with the school’s link
educational psychologist (EP) to consider the need for a co-ordinated, multiagency response.
9. Support for staff
Responding to and supporting pupils who self-harm can be emotionally
demanding. It is also acknowledged that some individuals may find this type of
work particularly demanding due to their own experiences. Staff involved in
this area of work should have the opportunity to discuss this with colleagues
and/or appropriate professionals such as the school’s EP. In addition, staff
should attend suitable training to support their role.
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